National Meeting on Active Duty and Vet Womens Health Part 4 Sexual Assault/Military Sexual Trauma


>>GOOD AFTERNOON, EVERYONE.
WE’LL CONTINUE WITH OUR MEETING TODAY.
NEXT I WOULD LIKE TO INTRODUCE A VETERAN WHO WILL BE SHARING HER
PERSONAL EXPERIENCE. SHURHONDA LOVE IS A SERVICE
CONNECTED DISABLED VETERAN, APPOINTED TO ASSISTANT NATIONAL
LEGISLATIVE DIRECTOR DISABLED AMERICAN VETERANS
AND NATIVE OF DALLAS, TEXAS, SHURHONDA ENLISTED IN THE TEXAS
ACADEMY NATIONAL GUARD IN ’90 AND JOINED THE REGULAR ARMY IN
1995 AND SERVED AS MEDIC UNIT SO SHE WAS DISCHARGED AS A RESULT
OF SERVICE CONNECTED DISABILITIES IN DECEMBER OF
2002. LET’S JOIN DAV, DISABLED
AMERICAN VETERANS, PROFESSIONAL STAFF AT NATIONAL SERVICE
OFFICER IN 2008 IN MONTGOMERY, ALABAMA.
SHE CURRENTLY SERVED ON THE DEPARTMENT OF VETERAN AFFAIRS
GERIATRIC AND GERONTOLOGY ADVISORY COMMITTEE.
I’LL LET HER TELL MORE OF HER STORY.
SHURHONDA LOVE.>>ARE THERE ANY QUESTIONS?
SO BEFORE I GOT UP HERE I WAS TRYING TO FIGURE OUT WHERE DO
YOU START WHEN YOU’RE TRYING TO TELL YOUR STORY.
BECAUSE TRUTH IS WE HAVE MANY STORIES AND ALL OF THEM ARE
PRETTY VALUABLE TO US. SO I GUESS I’LL GIVE A LITTLE
HISTORY, WE’LL START THERE, BECAUSE YOU WANT TO GO HOME
TODAY, RIGHT? I JOINED THE MILITARY IN ’90 IN
THE TEXAS NATIONAL GUARD AND SOMETHING THAT WE SAY IN THE
ARMY IS I LIKED IT, I LOVED IT, I WANT MORE OF IT.
SO I WENT INTO ACTIVE DUTY. I WAS PRETTY GOOD AT WHAT I DID
BUT BEFORE I GO INTO THAT, LET ME ASK YOU A QUESTION.
WHY DO YOU THINK MOST MILITARY SERVICE MEMBERS, WHY DO YOU
THINK WE JOIN? JUST ANYBODY. (OFF MIC)>>EDUCATION.
SO THE PATRIOTISM WAS THERE BUT WHAT STARTED IT FOR ME IS BACK
IN THE DAY WHEN THE TVs USED TO GO OFF BEFORE THEY WENT OFF
THERE WAS A FLY OVER THE AIR FORCE USED TO DO AND THEY WOULD
PLAY THE NATIONAL ANTHEM THEN YOU GET THE BARS ON THE TV AND
THE JETS WOULD GO OVER AND I WAS THERE LIKE — SO THAT STARTED
IT. HOWEVER, REALISTICALLY SPEAKING
I WANTED TO LIVE MY LIFE ON MY OWN, I DIDN’T WANT TO BE A
BURDEN TO MY MOTHER, SHE WAS WORKING TWO JOBS TRYING TO TAKE
DARE OF ME SO I JOINED THE MILITARY.
THE EDUCATIONAL ASPECT, A BETTER LIFE, BEING DIFFERENT FROM MY I
GUESS CIVILIAN FRIENDS, I JUST WANTED MORE AND I KNEW THAT THE
MILITARY COULD OFFER ME THAT. SO I CAN SAY THAT I EXCELLED AS
A SOLDIER, IF YOU’RE IN THE MILITARY YOU KNOW YOUR ARMY
REGULATIONS OR WHATEVER IT IS THAT GOVERNS YOU THEN YOU CAN
EXCEL IN IT. AND I DID PRETTY GOOD AT THAT.
I BECAME A NON-COMMISSIONED OFFICER SERGEANT.
I BECAME A LEADER. THESE THINGS GAVE ME PURPOSE.
BEING A COMBAT MEDIC I DID NOT SEE SOME BAT BUT BEING A MEDIC
AND KNOWING HOW IMPORTANT MY JOB WAS, HOW IMPORTANT THE TRAINING
WAS THAT I WAS GETTING, THAT GAVE ME MORE PURPOSE, MORE
DIRECTION AND MY JOB MADE IT EVER SO CLEAR TO ME THAT I MUST
TAKE IT SERIOUSLY. SO I EXCELLED IN IT, I WAS GOOD,
I DON’T KNOW ABOUT YOU BUT FOR I GUESS SOME CALL ME LIKE A TYPE
PERSONALITY. I DON’T THINK SO BUT BUT YOU
START TO SET GOALS. SO I HAD THREE THINGS THAT I
WANTED TO DO IN THE MILITARY. THREE.
BECOME A DRILL SERGEANT, BECOME A FIRST SERGEANT AND BECOME A
COMMAND SERGEANT MAJOR IN THAT ORDER.
SO AS I WAS GOING THROUGH MY CAREER AND LEARNING AND TEACHING
AND LEADING AND FOLLOWING, I ENCOUNTERED AN INJURY.
SO ONE PERMANENT PROFILE IS NOT A DISBAR TO DUTY.
SO YOU GO THROUGH IT, YOU GET A PERMANENT PROFILE, THEY MODIFY
YOUR ACTIVITIES, BUT YOU’RE ABLE TO CARRIEN AS A ACTIVE SERVICE
MEMBER. SO I GO ON AND I GET TO SAN
ANTONIO AND I ENCOUNTER AN ILLNESS THAT I HAD BATTLED WITH
BEFORE BUT IT WAS NEVER DIAGNOSED BECAUSE MILITARY
PEOPLE DO, WE DO WELL, WE HIDE. WE KNOW HOW TO HIDE EVERYTHING.
WE HIDE OUR MENTAL HEALTH, WE HIDE OUR PHYSICAL PAIN, EARLIER
SOMEONE MENTIONED INJURY AND BASIC TRAINING.
A LOT OF PEOPLE WERE INJURED. I INJURED MY SHOULDER IN BASIC
TRAINING BUT YOU THINK I SAID ANYTHING?
I WANT TO COME HOME, I CAN’T TELL MY MOM I FAILED.
SO MANY SERVICE MEMBERS THEY CAN’T COME HOME AND SAY THEY
FAILED OR ONCE AT HOME. SO YOU GO THROUGH, YOU GO ON.
SO I WENT ON. BUT THEY FOUND THAT THAT ILLNESS
DESERVED TO HAVE A PHYSICAL EVALUATION BOARD BECAUSE I HAD
TWO NOW PERMANENT PROFILES. AND THIS IS WHEN THINGS STARTED
TO CHANGE FOR ME. THIS IS WHEN LIFE GOT A LITTLE
SCARY BECAUSE I HADN’T BECAME A FIRST SERGEANT YET.
I HADN’T BECAME A DRILL SERGEANT YET.
I WAS NOT THE COMMAND SERGEANT MAJOR OF THE ARMY YET.
SO I WENT THROUGH MY PHYSICAL EVALUATION BOARD.
AND I CAN TELL YOU, IF YOU HAVE NEVER BEEN THROUGH ONE OF THOSE,
IT’S NOT A PLEASANT FEELING. NUMBER ONE, YOU KNOW THAT YOU
ARE BEING EVALUATED TO WHETHER YOU’RE GOOD ENOUGH TO STAY IN,
THAT’S WHAT IT FELT LIKE. BASICALLY IT’S WHETHER YOU CAN
DO YOUR DUTIES. BUT IT DOESN’T FEEL LIKE IT’S
WHAT’S HAPPENING. IT FELT LIKE OH, YOU DON’T WANT
ME ANY MORE, I GOT A FEW INJURIES BUT I GOT THEM HERE.
AS I’M GOING THROUGH THIS PRO PROCESS I’M A LITTLE SCARED
BECAUSE I DON’T WANT TO GET OUT AND I KNOW THAT’S A POSSIBILITY
BECAUSE IT’S LATER IN MY CAREER, NOT LATER IN MY CAREER BUT JUST
UNPLANNED. I DON’T HAVE THINGS IN PLACE.
SO I’M REALLY SCARED ON TOP OF GOING THROUGH ALL THIS.
SO I STARTED SOME MENTAL THINGS BUT NOBODY NOTICED IT BECAUSE
THE A TYPE PERSON, SHE’S FINE, YOU DON’T SEE IT.
YOU CAN’T SEE IT. SO IT’S HIDDEN.
SO FINALLY I GOT TO A POINT WHERE THEY PLEATY MUCH SAID
PRETTY MUCH SAID YOUR CONDITIONS ARE UNFITTING FOR THE MILITARY
TO STAY IN THE ARMY. AND I GOT OUT.
AND THAT IS THE POINT WHERE DEPRESSION I DIDN’T KNOW I WAS
DEPRESSED BUT I CAN TELL YOU EACH DAY ON THE OUTSIDE, YOU TAKE CARE OF WHAT YOU KNOW TO TAKE
CARE OF, YOU GO TO WORK, YOU’RE THERE BUT YOU’RE NOT REALLY
THERE. YOU’RE THERE, YOU’RE PRESENT,
YOU’RE COLLECTING A CHECK BUT YOU’RE NOT THERE.
WHEN YOU GET HOME, YOU’RE HOME BUT I WAS LOST IN A VIDEO GAME
CALLED THE SIMS. IT’S A REALITY GAME WHERE YOU
HAVE AVATARS AND YOU HAVE THIS WORLD AND YOU CAN LIVE
PHYSICALLY, THIS PERSON HAS TO MAKE ENOUGH MONEY TO BUILD A
HOUSE AND PHYSICALLY HAS TO GET A JOB AND HAVE A FAMILY AND ALL
THESE THINGS, YOU HAVE TO BUILD THIS AVATAR, IT’S LIKE LIFE.
SO EACH DAY I WOULD COME HOME AND FROM THE TIME I GOT HOME, I
WOULD PLAY THAT GAME UNTIL I COULDN’T PLAY IT ANY MORE.
UNTIL SLEEP, THEN I WOULD GET UP AND DO THE WHOLE CYCLE AGAIN AND
AGAIN AND AGAIN UNTIL ABOUT A YEAR, MAYBE A LITTLE OVER A YEAR
AFTER A FAMILY MEMBER WAS LIKE YOU KNOW, YOU AREN’T DOING
ANYTHING ANY MORE. ANYBODY THAT KNOWS ME KNOWS I
LOVE MUSIC. YOU NEATER GOING TO DANCE, YOU
NOT GOING TO DANCE, YOU’RE NOT SINGING ANY MORE, ANYBODY
KNOWING ME FROM MILITARY KNOWS I LOVE TO SING.
IF YOU PUT A MICROPHONE IN FRONT OF ME, I ALMOST STARTED SINGING
TODAY, I KNOW THIS IS NOT THE PLACE, I DIDN’T FIND JOY IN
THOSE THINGS. I ALSO LOVED TO PLAY BASKETBALL,
THAT’S ONE OF THE BIGGER THINGS I LOST OUTSIDE OF LOSING MY
MISSION. I CAN’T SAY THE IMPORTANCE OF
UNDERSTANDING P. FIRST WHEN YOU GET OUT OF MILITARY ON YOUR OWN
TERMS YOU GET OUT AND YOU RETIRE, WHEN YOU LOSE THAT
MISSION, THAT’S A BIG LOSS. BUT TO LOSE AND YOU WEREN’T
READY, THAT’S EVEN BIGGER. WHETHER YOU’RE MEDICALLY
RETIRED, IT WASN’T ON YOUR TERMS.
IT WASN’T ON MY TERMS AND I WAS VERY, VERY, VERY ANGRY.
DIDN’T KNOW IT BUT I WAS. SO I GOT OUT, I STAYED DEPRESSED
FOR WHILE AND MY FAMILY MEMBERS LIKE SOMETHING AIN’T RIGHT.
SOMETHING IS NOT RIGHT. YOU NEED TO GET CHECKED OUT.
I WENT TO THE DOCTOR AND DEPRESSION.
BACK THEN, I MEAN PROBABLY I KNOW NOW THERE’S STILL A STIGMA
ON MENTAL HEALTH. BUT EVEN MORE SO IN THE AFRICAN
AMERICAN COMMUNITY, IT’S NOT AS EASILY EMBRACED AS IT SHOULD BE.
YOU’RE RELUCTANT TO GO BACK, RELUCTANT TO TELL ANYONE.
MY MOTHER DIDN’T FIND OUT UNTIL YEARS AFTER SO YOU HOLD ON TO
THAT AND ALL THESE THINGS AND YOU REMAIN THIS WAY.
SO LIKE I SAID, I LOST MY MISSION, BECAUSE OF MY
PERSONALITY, DIDN’T LOOK LIKE I NEEDED HELP, NOBODY NOTICED,
FEBRUARY THEY DID, THEY DIDN’T KNOW WHAT TO SAY.
IN THE COMMUNITIES IN OUR COMMUNITIES, MANY CIVILIANS,
THERE’S NOT A LOT OF US SO THEY DON’T KNOW WHAT TO SAY.
HOW DO YOU SAY YOU LOOK DIFFERENCE.
WHAT DO YOU MEAN I LOOK DIFFERENT?
SO PEOPLE JUST WALK BY, HOW ARE YOU DOING BUT THEY DON’T REALLY
MEAN IT. HOW YOU DOING.
I’M DOING THE FINE. ARE YOU REALLY?
YOU KNOW YOU SHOULD ASK THAT AND BE READY FOR THE ANSWER.
IN TRANSITIONING I THINK THE MAJOR THING THAT I WANTED TO SAY
ABOUT MY STORY IS THERE ARE A LOT OF PROGRAMS OUT HERE NOW FOR
PEERS, THAT VA DOES AND THERE’S ALSO LEGISLATION, COUNSELING AND
RETREAT SETTING THAT EACH YEAR IS POSITIVELY BEING RENEWED.
IT’S VERY MUCH NEEDED. RECENT LIP I ATTENDED A
RETREATED AND HAD THAT RETREAT. LAST YEAR, I GOT OUT OF THE
MILITARY IN 2002. BUT HAD I HAD SOMETHING LIKE
THAT WHEN I GOT OUT OF THE MILITARY, IT COULD HAVE SAVED ME
A LOT OF YEARS OF BROKEN RELATIONSHIPS, OF ABUSING AND
BEING ANGRY AT MYSELF, BEING MAD AT THE MILITARY, JUST A LOT OF
YEARS OF PAIN, HAD I HAD SOMETHING TO GIVE ME THE TOOLS
THAT THIS PROGRAM GAVE ME 10, 15 YEARS AFTER SERVICE.
15 YEARS OF PAIN THAT COULD HAVE BEEN LESS SEASONED.
SO/LESSENED. I WANT TO STRESS TO EVERYBODY,
DOD VA, IT’S VERY VALID TO HAVE PROGRAMS IN PLACE FOR VETERAN,
NO JUST WOMEN VETTIANS BUT ALL TO COME AND TRY TO GET A SENSE
OF COMMUNITY, A SENSE OF SELF-AS THEY’RE BEING DISCHARGEED FROM
THE MILITARY. BECAUSE WE HAVE LOST OUR
MISSION, WHETHER WE LOST IT ON OUR TERMS OR YOURS.
WE ARE LEAVING BEHIND SOMETHING THAT IS VERY DEAR TO US, WHAT IS
IMPORTANT. AND BEING SURROUNDED BY YOUR
PEERS IS A BIG THING. WHEN YOU LEAD THE MILITARY, THE
MILITARY IS A CITY. IT’S YOUR EVERYTHING IN ONE.
YOU GOT YOUR BASE, YOUR COMMISSARY, YOUR PX, YOUR
SHOPPING, YOUR GAS, EVERYTHING IN ONE SO YOUR COMMUNITY IS
SMALLER BUT WHEN YOU GET OUT, THAT COMMUNITY IS LIKE OH, GOSH
IT WAS A MAJOR DEAL FOR ME TO KEEP MY ID CARD.
THAT WAS LIKE NO, YOU’RE NOT GOING TO TAKE THAT FROM ME.
THEY OFFERED ME SEVERANCE. I DIDN’T WANT SEVERANCE.
I WANTED TO MEDICALLY RETIRE. THIS IS 12 YEARS OF MY LIFE.
AND YOU’RE PUTTING ME OUT, I WANT TO STAY.
I FOUGHT TO GET MY MEDICAL RETIREMENT.
SO I WANT TO STRESS TO YOU, I CAN KEEP YOU ALL DAY BECAUSE I
HAVE MORE. BUT I WANT TO STRESS TO YOU THE
IMPORTANCE OF HAVING THOSE PROGRAMS, THOSE PEER TO PEER
PROGRAMS. IN MENTAL HEALTH I CAN’T SAY IT
ENOUGH, HAVING PEERS BECAUSE NOT ONLY ARE THOSE PROGRAMS GOOD AND
YOU GET THE TRAINING, YOU ALSO BUILD NETWORKS.
AND THOSE LADIES THAT ARE THERE WITH YOU, THOSE COMRADES THERE
WITH YOU, KIND OF UNDERSTAND WHAT YOU HAVE GONE THROUGH AND
YOU CAN RELATE TO THEM. WITH THAT, I WILL TAKE ANY
QUESTIONS THAT YOU MAY HAVE. [APPLAUSE]>>DO YOU MIND SHARING WHICH
RETREAT PROGRAM YOU WENT TO AND WHAT IT WAS YOU THOUGHT THAT WAS
PARTICULARLY HELPFUL?>>SO I ATTENDED BOTH RETREATS.
AND I CAN TELL YOU THE PROGRAM WAS VERY WELL PUT TOGETHER FROM
ENTRY TO COMMIT. IT WAS CALLED WE WERE TRAINED
ON WHAT’S CALLED POST TRAUMATIC GROWTH.
IT’S MORE OF IT’S NOT WHAT’S WRONG WITH YOU, BUT IT’S WHAT
HAPPENED TO YOU. SO THEY TAKE A LOOK AT YOUR
WHOLE LIFE, BEGINNING BEFORE THE MILITARY, DURING THE MILITARY
AND NOW. AND THEY BASICALLY TEACH YOU HOW
TO DEAL WITH THOSE THINGS YOU EXPERIENCED AND THEY EXPOSE A
LOT OF THINGS THAT YOU MAY NOT EVEN KNOW EXISTS INSIDE OF YOU.
THEY GIVE YOU TOOLS TO PUT THAT BACK TOGETHER.
IT WAS AN EXPERIENCE BECAUSE I WAS ONE OF THOSE PEOPLE THAT
WERE AGAINST GROUP. I’M NOT GETTING IN IN THERE
TELLING ALL MY BUSINESS TO THESE PEOPLE.
EXPOSING MYSELF. BUT I CAN TELL YOU WE ALL DID
IT, WE CRIED TOGETHER. WE BROKE DOWN TOGETHER AND THEN
WE BUILT BACK UP TOGETHER. IT WAS A VERY GOOD EXPERIENCE
AND I WISH I WISH I WISH I HAD SOMETHING LIKE THAT WHEN I GOT
OUT.>>THANK YOU SO MUCH FOR SHARING
YOUR STORY WITH US. MY QUESTION TO YOU IS, IF YOU
CAN GIVE TRANSITIONING SERVICE MEMBERS OR VETERANS WHOSE ARE
STRUGGLING WITH THAT TRANSITION THREE TIPS OR THREE THINGS THAT
WOULD REALLY HELP THEM BE SUCCESSFUL, WHAT WOULD THEY BE?>>SLOW DOWN.
DON’T BE IN SUCH A HURRY TO GET OUT.
WHEN I GOT OUT I WAS ANGRY. SO ALL THOSE THINGS THAT WE HAD
A PAMPHLET, A BOOKLET OF THIS SERVICE IS HERE, THIS SERVICE IS
THERE, THIS SERVICE IS HERE. BUT YOU DON’T KNOW THAT YOU NEED
THOSE THINGS UNTIL YOU ACTUALLY NEED THEM.
SO ALL THAT DIDN’T MEAN ANYTHING TO ME.
I DIDN’T NEED THAT. SO SLOW DOWN AND READ THE
PAPERWORK. I WOULD LIKE ON THAT SAME TIP I
WOULD LIKE TO SAY TO DOD IS MAYBE NOT SO MUCH WHEN WE’RE
GETTING OUT BUT MAYBE BEFORE WE GET OUT OR MAYBE A YEAR OUT
AFTER WE GET OUT, FOLLOW UP. THEY’RE DOING THAT NOW BUT THAT
WASN’T HAPPENING WHEN I GOT OUT. THIS NOT SO MUCH AT ONCE BECAUSE
YOU’RE ALREADY OVERWHELMED. THE SECOND THING IS YOU’RE NOT
ALONE. SEEK OUT VETERAN SERVICE
ORGANIZATIONS, YOU GOT DDA DOD WOUNDED WARRIOR, RED WHITE AND
BLUE, YOU HAVE ALL THESE VETERAN SERVICE ORGANIZATIONS THAT HAVE
WOMEN, MEN, BUT THEY HAVE WOMEN IN THERE YOUR COMRADES AND KNOW
WHAT YOU ARE GOING THROUGH AND THEY’RE LOOKING FOR YOU BEING IN
MALE DOMINANT VETERAN SERVICE ORGANIZATION BEING IN ONE, I’M
LOOKING FOR MORE WOMEN, COME JOIN ME, PLEASE COME JOIN ME SO
WE CAN BUILD OUR NETWORKS AND GO OUT AND REACH OTHER WOMEN.
THIRD THING, BE HONEST WITH YOURSELF.
SOMETIMES PEOPLE WANT TO KNOW WHAT QUESTIONS TO ASK.
SO SOMETIMES YOU MIGHT HAVE TO TAKE THAT LEGAL AND KNOW
SOMEBODY WILL HELP YOU WHEN YOU SAY YOU NEED HELP.
ALLOW PEOPLE TO HELP YOU. THANK YOU. [APPLAUSE]>>GOOD AFTERNOON, EVERYONE.
WELCOME TO THE SEXUAL ASSAULT AND MILITARY SEXUAL TRAUMA PANEL
SESSION. MY NAME IS STEPHANIE ALEXANDER,
I’M WITH THE OFFICE ON WOMEN’S HEALTH AND I WILL BE THE
MODERATOR FOR THIS SESSION. WE HAVE TWO FANTASTIC SPEAKERS
TODAY. DR. SUSAN MCCUTCHEON AND KATE
MCGRAW WHO BRING A WEALTH OF EXPERIENCE TO SHARE ON THIS
IMPORTANT TOPIC. DR. SUSAN MCCUTCHEON SERVES AS
NATIONAL MENTAL HEALTH DIRECTOR OF FAMILY SERVICES, WOMEN’S
MENTAL HEALTH AND MILITARY SEXUAL TRAUMA, FOR THE OFFICE OF
MENTAL HEALTH SERVICES AND SUICIDE PREVENTION IN THE
DEPARTMENT OF VETERANS AFFAIRS. A MOUTHFUL.
SHE’S RESPONSIBLE (OFF MIC)
SHE IS RESPONSIBLE FOR DEVELOPING CLINICAL POLICY,
NATIONAL GUIDANCE AND DEFINING DIVISION OF MENTAL HEALTH
PROGRAMMING FOR HER AREAS OF RESPONSIBILITY.
DR. KATE MCGRAW IS DEPUTY DIVISION CHIEF OF THE
PSYCHOLOGICAL HEALTH CENTERS OF EXCELLENCE, DEFENSE HEALTH
AGENCY S SHE HAS LONG STANDING HISTORY WORKING WITH DOD HAVING
SERVED AS DOD CO-LEAD FOR A VA DOD INTEGRATED MENTAL HEALTH
STRATEGY TASK GROUP FOCUSED ON MENTAL HEALTH COMMUNITY NEEDS OF
FEMALE SERVICE MEMBERS AND VETERANS.
SO DR. MCGRAW, THE FLOOR IS YOURS.>>IF I CAN ASK THAT WE SAVE
QUESTIONS TO THE END OF BOTH PRESENTATIONS FOR THE SAKE OF
TIME. THANK YOU.>>THANK YOU FOR THAT KIND
INTRODUCTION AND IT’S AN HONOR AND PLEASURE TO BE HERE TODAY.
I WANT TO THANK CANDICE, WHERE ARE YOU SITTING, CANDICE?
FOR YOUR TREATMENT AND FOR INSPIRING ALL OF US TO GET
TOGETHER AND MAKE THAT HAPPEN. I ALSO WANT TO THANK SHURHONDA
FOR YOUR COURAGE TO SPEAK TO THE GROUP AND SHARE YOUR EXPERIENCE
WITH US. SO I’M GOING TO PUSH THIS BUTTON
IT MOVES. GREAT.
HERE IS MY DISCLOSE SHOE, THESE VIEWS ARE NOT THE OFFICIAL
POLICY OF DOD AND U.S. FEDERAL GOVERNMENT, NO FINANCIAL
INTERESTS TO DISCLOSE. TRUE MILITARY FASHION I WILL
TELL YOU I’M GOING TO TALK ABOUT THESE THINGS AND THEN I’M GOING
TO TALK ABOUT THEM THEN I WILL SUMMARIZE SO WE WILL LOOK AT
POLICIES AND PROGRAMS, A LITTLE BIT ABOUT PREVALENCE OF SEXUAL
ASSAULT, SOME RESEARCH EVALUATION THAT WE HAVE DONE,
TALK ABOUT SOME PROCEDURES AND MANAGEMENT IN THE MEDICAL
COMMUNITY OF SEXUAL ASSAULT DISCLOSURE AND GIVE YOU SOME
RESOURCES. BEFORE I CONTINUE HOW MANY OF
YOU IN THE AUDIENCE ARE CURRENTLY PROVIDERS, PROVIDING
CARE? EXCELLENT.
SO I’M HOPING TO LEAVE YOU WITH SOME REAL THINGS THAT YOU CAN
ACTUALLY TAKE BACK TO YOUR PREFACE. SO SEXUAL ASSAULT IN THE DOD,
SOME OF YOU MAY HAVE NOTICED ON THE AGENDA THE TITLE OF THIS IS
SEXUAL ASSAULT/MILITARY SEXUAL TRAUMA.
THE REASON THERE’S TWO TERMS IS THE DOD AND VA APPROACHED SEXUAL
ASSAULT DIFFERENTLY. SO IN THE DOD, WE HAVE A PROGRAM
CALLED THE SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM
AND THIS IS THE AGENCY THAT I DON’T HAVE SEES ANYBODY’S
COMPLAINT OF SEXUAL ASSAULT AND GOVERNED BY THESE REGULATIONS AS
YOU SEE IN FRONT OF US. OUR HEALTHCARE IS REALLY
INTENDED TO PROVIDE TIMELY HIGH-QUALITY GENDER SPECIFIC AND
TRAUMA INFORMED AS WE HEARD EARLIER TODAY, TRAUMA INFORMED
ADVOCACY AND HEALTHCARE FOR ANY PATIENT WHO COMES INTO OUR
FACILITY AN DISCLOSES SEXUAL ASSAULT.
THIS MIGHT BE MILITARY MEMBER, IT MIGHT BE A FAMILY MEMBER, IT
COULD BE A CIVILIAN OR EVEN A CONTRACTOR WORKING ON BASE.
THERE ARE OTHER ORGANIZATIONS IN DOD THAT HAVE EQUITIES AND
SEXUAL ASSAULT RESPONSE. SO WE TALKED ABOUT SAPRO, SEXUAL
ASSAULT PREVENTION RESPONSE, NOT INTIMATE PARTNER VIOLENCE WITHIN
RELATIONSHIPS OR FAMILIES. THEN WE HAVE THE FAMILY ADVOCACY
PROGRAM FOCUSING ON SEXUAL ASSAULT BETWEEN FAMILY MEMBERS
OR INTIMATE PARTNERS. IN ADDITION, THE DOD LOOKS AT
SEXUAL HARASSMENT AS A DIFFERENT KIND OF PROBLEM AND SO THERE’S A
SEPARATE OFFICE, THE ODEI WHICH LOOKS AT SEXUAL HARASSMENT ONLY.
THAT’S A DIFFERENCE IN THE VA, THE VA COMBINES THE TWO AND
CALLS IT MILITARY SEXUAL TRAUMA AND DOD SEPARATES IT OUT.
FINALLY WE HAVE A CRIMINAL INVESTIGATION ORGANIZATION THAT
INCLUDES CID AND CIS AND ASOSI AND THEY INVESTIGATE ANY
ALLEGATION OF SEXUAL ABUSE OR SEXUAL ASSAULT OR ANY FELONY
MISCONDUCT. SO WE DO HAVE POLICIES FOR THE
MEDICAL MANAGEMENT OF SEXUAL ASSAULT CURRENTLY, THE POLICY
THAT OVERSEES THE ENTIRE PREVENTION RESPONSE FOR SEXUAL
ASSAULT AND DOD HAS A SMALL PORTION THAT TALKS ABOUT WHAT
WE’RE SUPPOSED TO DO AS PROVIDERS IN THE MEDICAL CARE
SYSTEM. WHEN A PATIENT SPONSOR TELLS A
PROVIDER THERE’S THEY WERE SEXUALLY ASSAULTED.
WE ARE WORKING ON PROCEDURAL INSTRUCTION AND DEFENSIVE
DEPARTMENT OF DEFENSE INSTRUCTION THAT WILL
SPECIFICALLY WORK ON JUST THE HEALTHCARE RESPONSE.
SO EVENTUALLY WITHIN THE NEXT YEAR OR SO WE SHOULD HAVE A
SEPARATE POLICY FOR THAT. TALKING ABOUT PAST YEAR
PREVALENCE FOR SEXUAL ASSAULT WE DO A COUPLE OF THINGS.
WE DO A SCIENTIFIC SURVEY TO ESTIMATE PREVALENCE, AND THIS IS
AN ANONYMOUS SURVEY AND CURRENTLY INDICATES 4.3% OF
ACTIVE DUTY SERVICE WEB AND .6 OF ACTIVE DUTY SERVICEMEN SAY
THEY HAVE AN AN INCIDENCE OF SEXUAL ASSAULT IN 12 MONTHS
BEFORE BEING SURVEYED, THIS COMES FROM THE WORKPLACE GENDER
RELATION SURVEY. THIS MEANS THAT AT LEAST EIGHT
AND A HALF THOUSAND WOMEN AND 6300 MEN EXPERIENCE PENETRATIVE
OR CONTACT SEXUAL ASSAULT IN FISCAL YEAR 2016.
AND I WANT TO PAUSE HERE TO SAY WHILE THIS TALK ISN’T ABOUT
ALMOST AS MANY MALES HAVE BEEN SEXUALLY ASSAULTED.
WE ARE TRYING TO EMPHASIZE THAT IN THE DEPARTMENT OF DEFENSE AS
WELL TO HELP RESPONSE FOR MALE VICTIMS.
32% SURVEY ESTIMATED SEXUAL ASSAULT VICTIMS ACCOUNTED FOR
INFORMAL SEXUAL ASSAULT REPORTS, THINK ABOUT THAT FOR A MOMENT.
SO IT’S ANONYMOUS SURVEY IS TELLING US A CERTAIN NUMBER OF
ASSAULTS ARE I CAN TAKING PLACE, OUR FORMAL REPORTING PROCESSES
ARE NOT CAPTURING THAT, WE’RE ONLY CAPTURING 32% OF WHAT’S
HAPPENING. SO IN FISCAL YEARS 17, WE HAD 6,700 REPORTS OF
SEXUAL ASSAULT, THESE ARE THE FORMAL REPORTS, AND 10% OF THOSE
REPORTS WERE FOR INCIDENCE THAT OCCURRED PRIOR TO MILITARY
SERVICE SO WHILE WE DO PROVIDE SUPPORT FOR INDIVIDUALS WHO HAVE
BEEN SAL SEXUALLY ASSAULTED IN SERVICE WE ALSO PROVIDE SUPPORT
AND RESPONSE FOR PEOPLE THAT HAVE BEEN ASSAULTED BEFORE
SERVICE BUT SEEKING CARE IN THE DOD.
THE PREVALENCE HAS DECREASED BY HALF FOR MEN AND BY A THIRD FOR
WOMEN SINCE FISCAL YEAR 2012 BUT REPORTING IS INCREASED OVER 88%.
SO THAT’S KIND OF INTERESTING TO THINK ABOUT THAT.
WE’RE NOT WE DON’T KNOW WHAT’S CAUSING THAT BUT WE DO NOTICE
THAT’S BEEN A CHANGE. AGAIN, STILL TWO-THIRDS OF THOSE
INDIVIDUALS WHO HAVE BEEN VICTIMMED VICTIMIZED ARE NOT
REPORTK SEXUAL ASSAULT. SO WHAT WE DO IN MY WORKPLACE
ENVIRONMENT WHICH IS WORKER WORKPLACE PSYCHOLOGICAL WE FOCUS
ON MENTAL HEALTH NEEDS AND PARTICULARLY WOMEN SERVICE
MEMBERS IN THIS SETTING, WE WILL BE TALKING ABOUT THOSE.
BUT WE WANTED TO KNOW HOW MUCH DO PROVIDERS ACTUALLY CODE
SEXUAL ASSAULT DISCLOSURE. AND SPEAKS TOWER FUNDING, IT
SPEAKS TO RESOURCING, WE NEED TO KNOW WHAT’S GOING ON AND MAKE
SURE WE’RE CAPTURING MAYBE PATIENTS COMING TO PROVIDERS AND
DISCLOSING BUT THEY’RE NOT REFERRING IN THE WAY TO GET
LEGAL SUPPORT AND LEGAL SERVICES THEY MIGHT BE ENTITLED TO.
SO WE DID A COMPARISON AND CODES ARE PRESENT IN ONLY .03% OF
MEN’S RECORDS AND IN .4% OF WOMEN’S RECORDS.
WITH AN AVERAGE OF 2.3 OUTPATIENT ENCOUNTERS PER SEXUAL
ASSAULT FOR BOTH SECONDS SO THAT’S UNDER, AGAIN UNDER WHAT
WE ESTIMATE SHOULD BE COMING INTO OUR PRIMARY CARE OR
SPECIALTY CARE CLINICS. SO WE THINK THIS IS A LAGGING
INDICATOR AND WHEN YOU COMPARE TO THE SURVEY PREVALENCE DATA
AND TO FORMAL PROGRAM REPORTING DATA WE SAY SOMETHING IS MISSING
AND WE DON’T KNOW WHETHER THE PATIENT ISN’T REPORTING AS MUCH
TO PROVIDER AS THEY ARE TO THE FORMAL SYSTEM OR IF PROVIDERS
ARE NOT DOCUMENTING IT IN THE MILITARY HEALTH RECORDS.
SO OUR TEAM WENT ON TO DO A SUMMARY LITERATURE REVIEW, WE
LOOKED ACROSS A NUMBER OF STUDIES FROM THE YEARS 2010
THROUGH 2016. WE INCLUDED IN THOSE STUDIES
ANYBODY LOOKING AT RESEARCH ON SEXUAL ASSAULT OR HARASSMENT AND
WE FOUND 136 PUBLICATIONS THAT MET SPECIFIC INCLUSION CRITERIA,
MOST CRITERIA FOCUSED ON VETERAN POPULATIONS.
NOT AS MUCH RESEARCH ON ACTIVE DUTY SERVICE MEMBERS RELATED TO
SEXUAL ASSAULT BUT WE DID COME ACROSS A NUMBER OF HIGH LEVEL
FINDINGS THAT I WANT TO SHARE WITH YOU.
AND SOME OF THEM IDENTIFY THAT THE RATES OF SEXUAL ASSAULT AND
SEXUAL HARASSMENT, DIFFER ACROSS STUDIES BUT THERE ARE
DIFFICULTIES AS WE DISCUSSED EARLIER, WITH PEOPLE COMING
FORWARD. WE DID SEE IN A LOT OF STUDIES
THAT THERE’S CORRELATIONS BETWEEN MENTAL HEALTH CONDITIONS
TO INCLUDE PTSD AND DEPRESSION, AS WELL AS SUBSTANCE USE
DISORDER. AND SEXUAL ASSAULT OR HARASSMENT
COUPLED WITH COMBAT EXPOSURE SIGNIFICANTLY INCREASES THE
RATES OF PTSD DIAGNOSIS FOR BOTH GENDERS.
WE SAW A NUMBER OF OTHER STUDY, I WON’T READ EVERY BULLET HERE,
I WANT TO HIGHLIGHT THAT THERE APPEARS TO BE AGAIN, THE SAME
CHALLENGE WITH SEEKING CARE, THE STIGMA AGAINST COMING FORWARD.
BUT ALSO LACK OF KNOWLEDGE OF AVAILABLE SERVICES THAT WERE
IDENTIFIED AS SIGNIFICANT BARRIERS FOR SERVICE MEMBERS.
WE IDENTIFIED A NUMBER OF GAPS IN RESEARCH, SO IF YOU ARE A
RESEARCHER LOOKING FOR TOICS TO LOOK AT WE NEED RESEARCH TO
EVALUATE GENDER DIFFERENCES AND BARRIERS ASSOCIATED WITH
UTILIZATION OF CARE ESPECIALLY IN RURAL REMOTE AREAS AS WELL AS
GENDER RESPONSIVE THERAPIES BECAUSE WE DON’T HAVE RESEARCH
TO GIVE GUIDANCE HOW TO PROCEED. WE TOOK THE GAPS THAT WE
DISCOVERED ACROSS THE PUBLISHED RESEARCH AND MAPPED THAT AGAINST
WHAT WE CURRENTLY HAVE IN OUR DOD PORTFOLIO.
. AND AT THE VERY END I HAVE BACK
UP SLIDES THAT SHOW YOU WHAT’S BUT STILL SOME GAPS REMAIN.
SO ONE OF THE CHALLENGES THAT THERE IS IN RESEARCH IS THAT WE
HAVE SMALL SAMPLE SIZES, WE HAVE POPULATIONS THAT DIFFER ACROSS
ACTIVE DUTY AND VETERANS BASED ON CONSTRUCTS AND TERMINOLOGIES,
SO SOME RESEARCHERS IDENTIFY ACTIVE DUTY MEMBERS THAT ARE
VETERANS AND VICE VERSA. SO MAKES IT DIFFICULT THE
COMPARE. WHAT DID WE DO ONCE WE LOOKED
ACROSS RESEARCH? WE LOOK ACROSS POLICY, ACROSS
TREATMENT PROGRAMS, ARE THERE THINGS MISSING FOR HEALTHCARE
PROVIDERS THAT WE NEED TO BUILD? SO THE HEALTHCARE PROCEDURES
CURRENTLY OUTLINED INVOLVE SETTING UP A TEAM AT EACH
INSTALLATION, MAKING SURE A SAFETY ASSESSMENT IS DONE SO THE
INDIVIDUAL ASSAULTED FEELS SUPPORTED, MAKING SURE THE
INSTALLATION COMMANDER HAS A HIGH RISK RESPONSE TEAM IN
PLACE. MAKING SURE SEXUAL ASSAULT
DISCLOSURE IS TREATED AS HAHN EMERGENCY SITUATION FOR
HEALTHCARE PRIORITIZATION. AND HEALTHCARE PROVIDERS CONSULT
WITH A VICTIM BEFORE THEY DECIDE HEALTHCARE OPTIONS, THERE’S
ALWAYS VICTIM CENTERED. WE WERE ALSO HAPPY TO PUT
TOGETHER A SEXUAL ASSAULT ADVISORY GROUP, THIS IS TO
SUPPORT LOOKING AT MENTAL HEALTH NEEDS FOR PATIENTS WHO DISCLOSE
SEXUAL ASSAULT. AND WE WERE ASKED TO DEVELOP
SOME TYPE OF MATERIALS THAT CAN HELP PROVIDERS BE MORE
RESPONSIVE TO PATIENTS WHEN THEY CAME FORWARD WITH SEXUAL
ASSAULT. SO WE DID CREATE SOME PRODUCTS
AND WE ACTUALLY HAVE DESIGNED ENVIRONMENT OF CARE QUICK
REFERENCE CHART. MILITARY MEMBERS ARE DEPLOYED
ALL OVER THE WORLD, ACTUALLY, AND SO WE TOOK A LOOK AT THE
POLICY AND NARROWED DOWN THIS UNWIELDY DOCUMENT TO A FEW SHORT
CARDS THAT SHOW YOU AT A GLANCE WHAT YOU SHOULD DO IF YOU’RE A
PROVIDER IN ANY ONE OF THESE AREAS.
WE DO HAVE THESE IN THE AREA WHERE THERE’S EXHIBITORS TABLES
SO IF YOU ARE INTERESTED YOU CAN PICK SOME UP AT OUR ACTIVE
DUTY GUARD, RESERVE OR MEMBER AND YOU’RE DEPLOYED OVERSEES AND
OVERSEES LOCATION, WHAT SERVICES ARE YOU ENTITLED TO, WHO DO YOU
SEE NEXTK HOW DO YOU GET HOLD OF THIS PERSON, WHAT THINGS ARE THE
PROVIDER NEEDS TO DO SO A QUICK CHECKLIST AND REFERENCE.
IF YOU’RE CIVILIAN PROVIDER IT’S HELPFUL TO KNOW THESE ARE THINGS
YOUR PATIENT IS ABLE TO GET AND WE ARE HAPPY TO PROVIDE TO THEM
DEPARTMENT OF DEFENSE. SO WHAT ARE THE KEY TAKE AWAYS?
I WANT YOU TO KNOW WE ARE COMMITTED TO ADDRESS AND RESPOND
TO SEXUAL ASSAULT DISCLOSURE, NOT JUST NON-INTIMATE BUT ALSO
INTIMATE PARTNER AND CHILD SEXUAL ASSAULT.
SINCE 2012 NON-INTIMATE SEXUAL ASSAULT REPORTING INCREASED
WHILE PREVALENCE DECREASED. HOWEVER WE BELIEVE THAT IT’S
STILL JUST ABOUT A THIRD OF SEXUAL ASSAULTS ACCOUNTED FOR SO
WE HAVE UNDERREPORTING. WE HAVE ENCLOSURE THAT OUTLINES
DIRECT HEALTHCARE PROVIDER PROCEDURES, AND WE ARE WORKING
ON REVISED VERSION OF THIS REVISED VERSION SPECIFIC JUST TO
HEALTHCARE. HEALTHCARE PROVIDERS IN THE
PURCHASE CARE, THAT WOULD BE ANYBODY IN THE ROOM THAT’S A
TRICARE PROVIDER OR HELPING OUT WITH TAKING CARE OF SERVICE
MEMBERS, WE’RE ENCOURAGING YOU TO BE AWARE OF RESOURCES AND
SUPPORTS AVAILABLE FOR PATIENTS WHO HAVE BEEN SEXUALLY ASSAULTED
AND ENCOURAGE YOU TO CODE THE ENCOUNTER AS A SEXUAL ASSAULT TO
TRACK WHAT THE HEALTHCARE DEMAND IS SO WE CAN RESOURCE IT
APPROPRIATELY. THEN PLEASE LOOK AT THOSE
ENVIRONMENT OF CARE QUICK REFERENCE CHARTS SO YOU CAN HAVE
THAT TO YOUR DISPOSAL AS QUICK REFERENCE.
HERE IS RESOURCE LINKS THAT YOU CAN LOOK AT, A WHOLE BUNCH OF
WEBSITES, EACH BRANCH OF SERVICE HAS THEIR OWN INITIATIVE TO
PREVENT SEXUAL ASSAULT. HERE ARE SOME REFERENCES THAT
INCLUDE SOME OF THE POLICIES AND A SPECIAL THANKS TO OUR Ph.D.
EVIDENCE BASED PRACTICE TEAM FOR SUPPORT FOR THEIR WORK IN
SUPPORTING THE PRESENTATION, AND IN THE BACK UP SLIDES AGAIN HERE
IS THE SUMMARY RESEARCH GAPS AND WHAT INVESTIGATIONS ONGOING IN
THE DOD. AND RELEVANT POLICIES.
THAT’S IT FOR ME SO I’LL PASS IT TO SUSAN. [APPLAUSE]>>I WAS GOING TO TO SAY I SURE
WISH I WAS BUT UNFORTUNATELY I’M NOT.>>BACK TO ME.
OKAY. I WOULD LIKE TO ECHO KATE’S
THANKS FOR INCLUDING SEXUAL ASSAULT IN TODAY’S AGENDA.
THIS IS A VERY IMPORTANT TOPIC AND WE REALLY APPRECIATE THE
OPPORTUNITY TO TALK ABOUT IT. AND TALK ABOUT THE DIFFERENCES THAT DO OCCUR BETWEEN DOD AND VA
AND THE DIFFERENT SERVICES. I ALSO LIKE THE THANK SHURHONDA
FOR YOUR PRESENTATION, WE APPRECIATE YOUR HONESTY AND
WILLINGNESS TO TALK TO US ABOUT YOUR EXPERIENCES, IT’S SO
HELPFUL TO US. THANK YOU.
FIRST AS KATE ALLUDED TO, THERE WITHIN VA AND DOD WE TALK SEXUAL
ASSAULT AND HARASSMENT DIFFERENTLY.
FOR VA WE TALK MILITARY SEXUAL TRAUMA.
THAT’S A TERM USED BY VA, IN FEDERAL LAW, TO REFER TO
EXPERIENCES OF SEXUAL ASSAULT OR REPEATED THREATENING SEXUAL
HARASSMENT THAT OCCURRED DURING VETERAN’S EXPERIENCE, ON BASE,
OFF BASE, WHILE AN INDIVIDUAL IS ON DUTY, OFF DUTY, THE IDENTITY
OF THE PERPETRATOR DOESN’T MATTER TO US.
THE REASON FOR THE ASSAULT HARASSMENT ALSO DOES NOT MATTER.
THIS INCLUDES ANY SEXUAL ACTIVITY IN WHICH SOMEONE IS
INVOLVING HIS OR HER WILL, IT CAN INCLUDE THAT SOMEONE WAS
PHYSICALLY FORCED TO PARTICIPATE.
THEY WERE INTOXICATED OR THEY WERE PRESSURED INTO THE SEXUAL
ACTIVITIES. THEY CAN INCLUDE THREATENING A
SENSE OF REMARKS, THREATENING OR UNWELCOMING SEXUAL ADVANCES OR
UNWANTED TOUCHING OR GRABBING. WHEN SCREENED BY VA PROVIDERS WE
FIND ABOUT ONE IN FOUR WOMEN AND ONE IN 100 MEN SCREEN POSITIVE
FOR EXPERIENCES IN MILITARY SEXUAL TRAUMA.
AND ALTHOUGH IT’S MUCH MORE PREVALENT IN WOMEN YOU CAN SEE
BY ONE IN FOUR, SINCE THERE’S SO MANY MORE MEN WITHIN THE VA
HEALTHCARE SYSTEM THE NUMBERS ARE PRETTY SIMILAR.
ABOUT 40% OF THE MEN IN OUR CARE VA HEALTHCARE SYSTEM HAVE
EXPERIENCED MILITARY SEXUAL TRAUMA.
ABOUT TEN YEARS AGO THERE WAS MORE MEN THAN WOMEN WHO
EXPERIENCED MILITARY SEXUAL TRAUMA THOUGH SOMETIMES WE THINK
OF IT AS AN EXPERIENCE THAT HAPPEN TO WOMEN.
VETERANS FROM ALL ERAS REPORTED THESE EXPERIENCE, IT’S JUST NOT
WE’RE NOT SEEING INCREASE WITH OUR NEWEST VETERANS.
RELATIVE TO TO OTHER FORMS OF TRAUMA, MTST CAN BE IMPACTFUL ON
ONE’S MENTAL HEALTH. RESEARCH HAS SHOWN OFFICIAL IS
MORE LIKELY TO RESULT IN SYMPTOMS OF PTSC MORE THAN ANY
OTHER TYPES OF TRAUMA, INCLUDING COMBAT.
WE SEE SIMILAR TYPE OF REACTION COMPARISON CIVILIAN SEXUAL
ASSAULT, WHERE THERE’S MORE LIKELY TO DEVELOP PTSD WHEN
COMPARED TO CIVILIAN SEXUAL ASSAULT.
THERE’S MUCH MORE ALSO MENTAL HEALTH CONSEQUENCES WITH
MILITARY SEXUAL TRAUMA. VA REALLY TRIES TO PUT A OF
PROMOTIONAL MATERIAL TO HELP WITH OUTREACH.
THIS IS ONE EXAMPLE OF SOME INFORMATION PUT OUT WE TRY TO
MAKE INFORMATION VERY REPRESENTATIVE OF ALL OF OUR
VETERANS. I WANT TO TALK A LITTLE BIT
ABOUT MST DISABILITY RELATED COMPENSATION.
VA IS DIVIDED TO THREE DIVISIONS SO TO SPEAK.
THERE’S HEALTHCARE, THERE’S BENEFITS AND THERE’S CEMETERY.
AND WITH BENEFITS LIKE ANY INJURY THAT OCCURS DURING THE
MILITARY, PEOPLE CAN BECOME SERVICE CONNECTED OR RECEIVE A
DISABILITY BASED ON MOST LIKELY PT SECOND QUARTERD FROM
EXPERIENCES MILITARY SEXUAL TRAUMA, VBA IS RESPONSIBLE FOR
THAT AND EVERY OFFICE HAS A COORDINATOR SPECIFICALLY GOING
TO HELP THAT VETERAN GET THOSE BEENS.
AS FAR AS STABILITY THERE’S CONFUSION YOU HAVE TO BE SERVICE
CONNECTED OR HAVE BENEFITS TO GET FREE MST RELATED CARE.
WHICH IS NOT TRUE. YOU CAN GET FREE CARE BY
SCREENING POSITIVE. YOU DO NOT HAVE TO FILE A CLAIM
WHEN OCCURRED, IT’S NOT REPORTS EXPERIENCES YOU DON’T
NEED THE INITIATE IT DURING CERTAIN TIME BETWEEN THAT
EXPERIENCE AND THE VA SYSTEM. YOU MAY BE ABLE TO RECEIVE THAT
FREE MST RELATED HEALTHCARE EVEN IF YOU DON’T QUALIFY FOR OTHER
VA HEALTHCARE, LIKE TIME AND SERVICE OR INCOME.
AT THE VA SINCE 2007 WE HAVE A NATIONAL MST SUPPORT TEAM, THIS
SUPPORTS ALL OF OUR CLINICIANS IN THE FIELD TO PROVIDE MST
RELATED CARE AS WELL AS ENCOURAGE THE TWO MAKE SURE
BEST PRACTICES AND OTHER SUPPORTS SO THIS WE COORDINATE
MST RELATED EDUCATION TRAINING, WE PROMOTE BEST PRACTICES, WE
HAVE NATIONAL PROVIDING CONSULTATION TO VA CENTRAL
OFFICE AS FAR AS POLICIES AND REVIEWING OTHER REQUESTS FROM
STAKEHOLDERS. EVERY VA MEDICAL CENTER ACROSS
THE COUNTRY HAS MST COORDINATOR, THAT PERSON IS RESPONSIBLE FOR
ADDRESSING ANY SYSTEM COORDINATION OF CARE, MST
RELATED EDUCATION AND TRAINING, CLINICIAN PROVIDES SOME CLINICAL
CARE, AND THERE IS POINT OF CONTACT FOR ANSWERED QUESTIONS.
GET HOLD OF A THE AMNESTY COORDINATOR CALL THE FACILE AND
ASK TO SPEAK TO THE COORDINATOR. RECOGNIZING THAT OUR VETERANS
COME TO US DON’T ALWAYS REVEAL THAT THE EXPERIENCE SEXUAL
TRAUMA WE HAVE UNIVERSAL SCREENING FOR VETERANS TO COME
TO THE VA. IT’S A KEY WAY TO ENSURE THAT
OUR VETERANS ARE AWARE OF THE FREE SERVICES THAT ARE AVAILABLE
AND TO ENSURE PROVIDERS ARE AWARE THAT VETERAN HAS
EXPERIENCE. AND CONVEY SENSITIVITY AWARENESS
OF THIS EXPERIENCE. UNIVERSAL SCREENING QUESTIONS ARE THIS.
WHEN YOU WERE IN THE MILITARY, DID YOU RECEIVE UNWANTED
THREATENING OR REPEATED SEXUAL TENSION FOR EXAMPLE TOUCHING
PRESSURING FOR SEXUAL FAVORS OR INAPPROPRIATE ET CETERA, THE
SECOND QUESTION IS WHEN YOU WERE IN THE MILITARY, DID YOU HAVE
SEXUAL CONTACT AGAINST YOUR WILL AND WHEN UNABLE TO SAY NO, FOR
EXAMPLE, AFTER BEING FORCED OR THREATENED TO I A VOID
CONSEQUENCES. YOU CAN ANSWER YES, NO OR
DECLINE. IF THE PERSON ANSWERS YES,
THEY’RE IMMEDIATELY OFFERED A REFERRAL FOR MENTAL HEALTHCARE.
THERE’S NO QUESTIONS ON WHEN DOES THIS OCCUR, WHO WAS THE
PERPETRATOR, WHAT DID YOU DO, WERE YOU DRINKING, IT’S SIMPLY
THOSE THREE QUESTIONS. COW DON’T HAVE TO HAVE EVIDENCE
JUST YES OR NO. IF YOU SAY YES, POSITIVE AND
YOU’RE OFFERED FREE MENTAL HEALTHCARE, PHYSICAL HEALTHCARE
AND ACCESS TO PHARMACEUTICALS. WHAT WE OTHER FINDING IS WE’RE
SEEING INCREASE IN THOSE INDIVIDUALS WHO SCREEN POSITIVE
AND THEN GO ON TO GET TREATMENT. ALMOST 79% OF THE WOMEN WHO
SCREEN POSITIVE AND 68% OF THE MEN THEN TAKE UP THE OFFER FOR
REFERRAL FOR TREATMENT AND GOTTEN TREATMENT.
LAST TEN YEARS THAT’S BEEN INCREASE IN 259% OF WOMEN AND
199% OF SO VERY DRAMATIC INCREASE.
WE DON’T SEE INCREASE PREVALENCE SCREENING POSITIVE BUT THOSE
THEN THAT GO ON TO GET TREATMENT IS REALLY DRAMATICALLY
INCREASING. AND WE THINK THAT’S BECAUSE OF
OUR OUTREACH AND WE BELIEVE WE PROVIDE VERY RELATED TO
MILITARY SEXUAL TRAUMA. MENTAL HEALTH SERVICES, WE HAVE
MST RELATED OUTPATIENT SERVICES EVERY VA ACROSS THE COUNTRY SO
GO TO ANY VA SERVICES INCLUDE ASSESSMENT EVALUATION
PSYCHIATRY, INDIVIDUAL AND GROUP THERAPY, WE ALSO IN ADDITION TO
GENTLEMEN TALL HEALTH WE HAVE SPECIALTY CARE AND TARGETS
PROBLEMS SUCH ADS PTSD ADDICTION, DEPRESSION,
HOMELESSNESS. AND COUNSELING IS ALSO AVAILABLE
AT VET CENTERS, COMMUNITY BASED FACILITIES THAT HAVE COUNSEL LUG
BUT DON’T PREVENT PROVIDE MEDICAL CARE.
FOR VETERANS WHO NEED MORE INTENSE TREATMENT WE HAVE
RESIDENTIAL PROGRAMS THROUGHOUT THE COUNTRY.
SOME TARGET SPECIFIC CONDITIONS, A NUMBER OF THESE FOLKS
PROGRAMS FOCUS ON MILITARY SEXUAL TRAUMA OR SPECIALIZED MSC
TRACKS. THEY’RE ALSO MENTAL HEALTH
INPATIENT PROGRAMS FOR STABILIZATION AND MEDICATION
ADJUSTMENT. VA RECOGNIZES THAT GENDER
SPECIFIC ISSUES ARE GREAT IMPORTANCE TO CARE.
IN VA FACILITIES WE HONOR REQUEST BUSINESS VETERAN WHOSE
HAVE TO HAVE A CERTAIN GENDER PROVIDER IF THEY WISH.
WE HAVE SINGLE GENDER AND MIXED GENDER PROGRAMS AVAILABLE.
AVAILABILITY OF THESE TYPES OF PROGRAMS DIFFER FROM MEDICAL
CENTER TO MEDICAL CENTER. WE KNOW MSC IS ASSOCIATED WITH
INCREASE RISK OF SUICIDE, EVEN AFTER ACCOUNTING FOR OTHER
MENTAL HEALTH CONDITIONS SO TO ENSURE OUR STAFF HAS CORRECT
TRAINING WE MAKE SURE THAT IN THE VETERAN CRISIS LINE THEY
HAVE SPECIAL EDUCATION AROUND MILITARY SEXUAL TRAUMA.
WE ALSO MAKE SURE THAT THERE’S A GOOD CONNECTION BETWEEN MST
COORDINATOR AND SUICIDE PREVENTION SUICIDE PREVENTION
COORDINATORS, AND WITH MONITORING WE HAVE SUICIDE
RISKS, AND COORDINATORS RECEIVE AT THE FACILITIES SO INCREASED
COLLABORATION AND COORDINATE FOR THOSE SCREENING POSITIVE FOR MIT
AND ARE OF SUICIDE RISK. TO ACCESS CARE AS VA FACILITY
YOU CAN CONTACT AMNESTY COORDINATOR, ASK YOUR EXISTING
VA HEALTH PROVIDER FOR A REFERRAL OR THERE IS A WEBSITE
FOR INFORMATION. TO OFFER TO ACCESS VET CENTERS,
ALSO THERE IS CONTACT INFORMATION FOR YOU.
WE HAVE SOME OUTREACH MATERIALS, FIRST YOU SAW WE HAVE INFO
GRAPHS FOR JUST FEMALES, JUST MALES AND COMBINED INFORMATION.
TRANSITIONING SERVICE MEMBERS, WE HAVE MST RELATED INFORMATION
IN THE TAB AS WELL AS SEPARATION HEALTH ASSESSMENT.
AND DEFENSE HELP LINE ALSO HAS SPECIALIZED INFORMATION ON THE
TREATMENT PROGRAMS AS RELATES TO CARE AT VA.
WE HAVE ANSWERING THE CALL CAMPAIGN THAT WE HAVE HAD
PROBABLY THE LAST 8 YEARS, BECAUSE POINT THE WAY TO
ACCESS MST RELATED CARE USUALLY THROUGH THE COORDINATOR, WE WANT
MAKE SURE ALL VETERANS ARE CALLING SO THE FACILITY CAN
REACH THE COORDINATOR. SO ONCE A QUARTERS WE HAVE
PROBABLY SO MUCH A SECRET SHOPPER CALL WHERE A MALE STAFF
MEMBER AND FEMALE STAFF MEMBER CALL A MEDICAL CENTER
INDIVIDUALLY AND SAY THEY ARE VET RAP AND WANT TO SPEAK TO THE
MST COORDINATOR AND THEIR FACILITY IS RATED ON SUCCESS OF
BEING ABLE TO CONNECT THAT CALLER TO THE MST COORDINATOR.
SO IF YOU GET THROUGH THEY GET A GREEN MARK, IF ONLY ONE GENDER
GETS THROUGH, THEN A YELLOW AND IF NEITHER GET THROUGH, RED.
SO THEN THEY HAVE TO DO ACTION PLANS.
WE FIND THAT FRONT LINE STAFF DON’T KNOW ABOUT COORDINATORS OR
HOW TO REACH THAT PERSON. THIS IS IMPORTANT TO ACCESS CARE
AND WE WANT TO MAKE SURE THAT SYSTEM WORKS.
APRIL IS SEXUAL AWARENESS MONTH, WE HAVE A SPECIAL TEAM EVERY
YEAR, WE TYPICALLY HAVE PROJECTS WHERE EXPERIENCES WHO EXPERIENCE
NST HAVE T-SHIRT AND SUPPORT AND ALL STAFF AND VETERANS DISPLAY
PARTICULAR MESSAGES OF SUPPORT. WE DO A LOT OF EDUCATION.
WIDE VARIETY OF CLINICIANS TAKE CARE OF OUR EXPERIENCED MST.
WE HAVE MANDATORY TRAINING FOR MENTAL HEALTH PROVIDERS AND
PRIMARY CARE PROVIDERS. WE HAVE O BROAD RANGE OF
TRAINING CALLS AN NATIONAL CONFERENCE.
THIS IS OUR WEBSITE. MAKE THE CONNECTION IS A
WONDERFUL RESOURCE AND HAS STORIES OF VETERANS STORIES OF
RECOVERY AND SOME VETERANS WHO EXPERIENCED MST.
I WAS ALLOWED TO GIVE YOU A FEW SLIDES ON WOMEN’S MENTAL HEALTH.
BECAUSE I COVER THAT AREA. YOU PROBABLY ALREADY HEARD THAT
MORE AND MORE WOMEN ARE COMING TO THE VA LAST YEAR 44% OF WOMEN
VETERANS USE VA ACCESS MENTAL HEALTH SERVICES.
WE HAVE A WIDE VARIETY OF SERVICES OUTPATIENT SPECIALTY
EVIDENCE WAYED PRACTICES IN PATIENTS.
ONCE SOMETHING THAT WE DO THAT I’M PROUD OF IS OUR MONTHLY
TELECONFERENCE SYSTEM. WE HAVE MONTHLY CALLS, WE SOME
TOPICS LIKE MULTI-DISCIPLINARY TREATMENT FOR EATING DISORDERS,
MENTAL HEALTH DURING MENOPAUSE, SUICIDE PREVENTION, WE ALSO
START A NEW PSYCHIATRY TELECONFERENCE SERIES AND SOME
SAMPLE TRAINING TOPICS ARE PSYCHOTHERAPY WITH POSTPARTUM,
SLEEP DISORDER, COMPLEX PTSD AND BORDERLINE PERSONALITY DISORDER,
THESE ARE WELL RECEIVED. TARGETED TOWARDS SUBSCRIBERS BUT
WE ALSO FIND NON-eS COME TO OUR CALL NON-SUBSCRIBERS COME
TO YOU ARE CALLS. TO OUR CALLS.
IN COLLABORATION WITH OUR PARTNERS IN WOMEN HEALTH
SERVICES WE DEVELOPED TREATMENT TRAINING.
THIS IS TRAINING BASED ON 216 JOINT COMMISSION STANDARDS,
PARTICIPANTS, APPLY AS TEAMS. WE MAKE SURE THAT THERE’S A
THERAPY, A MEDICAL PROVIDER AND A DIETITIAN AND INCLUDES
TRAINING ON ENHANCED COGNITIVE BEHAVIORAL THERAPY, MEDICATION
MANAGEMENT, PRIMARY CARE AND DIETARY SERVICES.
8 WEEKS, 24 HOURS TRAINING, IT COMES WITH CASE CONSULTATION.
TO DATE, 28 TEAMS ACROSS THE COUNTRY ARE TRAINED.
STAIR IS A SKILLS TRAINING AND EFFECTIVE AND INTERPERSONAL
REGULATION, IT’S A PROMISING PRACTICE FOR THE TREATMENT OF
PTSD. IT’S A COGNITIVE BEHAVIORAL
THERAPY THAT TEACHES SKILLS FOR MANAGING STRONG EMOTIONS AND
BUILDING HEALTHY INTERPERSONAL RELATIONSHIPS WHICH IS AN AREA
THAT MANY OUR WOMEN WITH HISTORIES OF MILITARY SEXUAL
TRAUMA STRUGGLE WITH. IT CAN BE USED ALONE OR IN AS A
COMPLIMENT TO OTHER PTSD TREATMENTS.
THIS IS A OUR COURSE, DEVELOPED IN PARTNERSHIP WITH
DEVELOPER, DR. MARLENE AND THE GOAL WAS TO PROVIDE A TREATMENT
OPTION, TO BE CONSISTENT WITH OUR VETERAN CENTRIC APPROACH.
SINCE 2014 WE HAVE TRAINED OVER 200 CLINICIANS IN THIS
INTERVENTION AND WE ARE GOING TO HAVE AN AVAILABILITY OF MORE
CASES IN NEXT YEAR. ONE THING WE FIND IS SO MANY
VETERANS WHO ARE PARENTS ARE SAYING PARENTING 101 IS NOT
HELPFUL, WE NEED SOMETHING CALLED PARENTING STAIR.
THIS IS AN ADDED MODULE, THAT WE ADAPTED FOR THE PARENT WHO’S
EMOTIONAL AND REGULATION IS IMPACTING THEIR PARENTING
SKILLS. SO THIS IS SOMETHING THAT WE
PILOTED A YEAR AGO AND NOW WE ARE OFFERING ON A REGULAR BASIS.
AND WE HAVE THIS AS A TRAINING CASE CONSULTATION.
KATE AND I ARE PROUD TO ANNOUNCE THAT TOMORROW WE START OUR MINI
RESIDENCY, A VA TARGETED TOWARDS PRESCRIBERS AS WELL AS
THERAPISTS AND SOME OF OUR BREAKOUT SESSIONS THE
PARTICIPANTS HAVE UP TO NINE OPTIONS OF TOPICS TO GO TO.
THIS WAY BOTH VA AND DOD MENTAL HEALTH CLINICIAN WHO FOCUS ON
WOMEN WILL BE RECEIVING THE SAME KNOWLEDGE ON BEST PRESCRIBING
PRACTICES BUT THERAPY PRACTICES. WE ARE THRILLED TO HAVE THIS
PARTNERSHIP. JUST BROAD CURRICULUM, AND FOR
THE VA I KNOW THAT AS PART OF THE DEAL YOU HAVE TO DEVELOP AN
ACTION PLAN TO TAKE SOME GENDER SENSITIVE INITIATIVE BACK TO
YOUR FACILITY AND WE CHECK ON YOU TO MAKE SURE THIS DOES GET
IMPLEMENTED. WE THANK YOU FOR YOUR
PARTNERSHIP AND SUPPORT. [APPLAUSE]>>THANK YOU VERY MUCH, THE
PRESENTATIONS WERE AWESOME. ARE THERE ANY QUESTIONS FOR OUR
TWO PRESENTERS? THERE’S MICS HERE AND THERE.>>GOOD AFTERNOON.
SO THANK YOU, DR. MCGRAW FOR USING THE TERM PRACTITIONER OR
PROVIDER.>>COULD YOU INTRODUCE YOURSELF?>>I’M SONYA COOK AND I’M THE
DIETITIAN AT THE TRICARE HEALTH CLINIC AT THE PENTAGON.
THE REASON I SAY THAT IS BECAUSE AS A DIETITIAN AND CLINIC THAT
HAS PREDOMINANTLY MALE PHYSICIANS, SO MANY SEXUAL
ASSAULTS ARE REPORTED TO ME. AS A FEMALE. BECAUSE AND I MAKE SURE I KNOW
WHO THE STARTS ARE, HOW TO GET IN CONTACT, WHAT ARE THE
PROCEDURES BECAUSE I DON’T EVEN PICK UP SCREENING FOR NUTRITION,
YOU’RE BING EATING THAT JUST STARTED SIX WEEKS AGO AND YOU
NOW HAVE A FEAR ALL FOODS THAT ARE WHITE.
WHAT HAPPENED SIX WEEKS AGO? AND ALL OF A SUDDEN THEY BREAK
DOWN AND START CRYING SO EVEN AS A DIETITIAN, THAT IS SOMETHING
THAT I DEAL WITH FREQUENTLY THAT NO ONE EVER TAKES INTO
CONSIDERATION. SO I’M INTERESTED IN THE
ADDITIONAL TRAINING AND I’M LUCKY BECAUSE I CAME FROM AIR
FORCE COMMAND AND EVERYONE HAD TO BE TRAINED BECAUSE IT WAS A
SERIOUS ISSUE WE WERE DEALING WITH.
SO THANK YOU VERY MUCH FOR THAT.>>YOU’RE WELCOME.
THE POINT IS WE WANT ANY PROVIDER REGARDLESS WHETHER THEY
WORK, REGARDLESS SPECIALTY AND STAFF TO BE AWARE OF WHAT TO DO
TO BE RESPONSIVE AND SUPPORTIVE WHEN SOMEONE DISCLOSES SEXUAL
ASSAULT. SO THANK YOU FOR COMING.>>THANK YOU.>>I’M DR. CONNIE NEWMAN,
PRESIDENT OF THE AMERICAN MEDICAL WOMEN’S ASSOCIATION.
I’M PROUD THE SAY I HAVE WORKED AT THE MANHATTAN VETERANS
HOSPITAL SINCE 1983. AND THANK YOU FOR YOUR
PRESENTATIONS. SO I HAVE COUPLE OF QUESTIONS.
FIRST ONE TO KATE MCGRAW. WHAT IS BEING DONE TO PREVENT
SEXUAL ASSAULT AND SEXUAL HARASSMENT IN THE MILITARY? DURING ACTIVE DUTY?>>THAT ANSWER THE QUESTION IS
LARGER THAN THE TOPIC OF THE TALK BUT IT’S A GREAT QUESTION.
AND THE DEPARTMENT OF DEFENSE SEXUAL ASSAULT PREVENTION AND
RESPONSE OFFICE IS A GROUP OF REALLY HARD-WORKING PEOPLE
DEDICATED TO ADDRESSING EXACTLY THAT.
AND THEY ARE LOOKING ACROSS DOD TO IDENTIFY THE BEST PRE-VENTION
PRACTICES AND IMPLEMENT THOSE. IN ADDITION, EACH SERVICE HAS
ITS OWN PROGRAM. AND REQUIRES TRAINING ANNUALLY.
TRAINING AT DIFFERENT LEVELS FOR DIFFERENT TYPES OF ROLES WHETHER
YOU’RE THE COMMANDER, THE FIRST SERGEANT, SUPERVISOR, PROVIDER.
SO THERE IS A COMPREHENSIVE DOD LEVEL POLICY.
THE WEBSITE IS REALLY COMPREHENSIVE.
AND THEN EACH SERVICE HAS THEIR OWN ADDITIONAL EFFORT TO TRY TO
ADDRESS AND REDUCE SEXUAL ASSAULT.>>THANK YOU.
I HAVE ONE OR QUESTION. HOW MANY PEOPLE REPORT THE
PERSON WHO COMMITTED THE SEXUAL ASSAULT, HARASSMENT?
IS THERE FEAR OF RETALIATION?>>SO I DON’T HAVE ACCESS TO
THAT NUMBER LIKE RIGHT NOW. WE’RE HAPPY TO TAKE DOWN YOUR
CONTACT INFORMATION AND CONNECT YOU WITH THE PEOPLE THAT WILL
HAVE THE CORRECT INFORMATION. THERE’S PROBABLY A LOT OF PEOPLE
THAT WILL WILL COME FORWARD AFRAID OF REPORTING BECAUSE OF
FEAR OF REPRIZAL SO THAT SPECIFIC FEAR IS BEING ADDRESS
IN THAT COMPREHENSIVE PLAN I MENTIONED, THEY’RE TARGETING REPRIZAL.
THEY’RE TARGETING BULLYING, OSTRACISM IN THE WORKPLACE TO
MAKE SURE THAT FOLKS ARE HELD ACCOUNTABLE AND BEING
REPRESENTED ON PERFORMANCE EVALUATION.
SO LIKE ALL THAT WORKPLACE DYNAMICS, THAT SUPPORT AND
INCREASE STIGMA AND REDUCE REPORTING IS WE’RE TRYING TO
ADDRESS IT. WE ARE TRYING TO ADDRESS IT.>>THANK YOU VERY MUCH.>>YOU’RE WELCOME.>>THANK YOU FOR YOUR QUESTION.>>GOOD AFTERNOON.
MY NAME IS SHARON HODGE, I’M DEPUTY DIRECTOR OF GOVERNMENT
AFFAIRS WITH THE VIETNAM VETERANS OF AMERICA.
APPRECIATE THE OPPORTUNITY TO BE HERE TODAY AND THANK YOU SO MUCH
FOR PUTTING ON THIS COLLABORATION BECAUSE I BELIEVE
THAT’S WHAT WE NEED TO GET OUR MESSAGE ACROSS TO OUR VETERANS,
ESPECIALLY OUR FEMALE VETERANS, I WANT TO SAY I’M SO PROUD TO
KNOW SHURHONDA AND I APPRECIATE ALL THE HARD WORK SHE DOES AND
SHE’S A TRUE VETERANS ADVOCATE. I WANT TO SAY I REALLY
APPRECIATE EVERYTHING SHE DOES FOR D DOD AND VETERANS.
CONGRESS PASS AD LAW THAT REQUIRES VA AND DOD GET TOGETHER
AND PROVIDE ACTIVE DUTY MILITARY WOMEN WITH MILITARY SEXUAL
TRAUMA COUNSELING FOR FREE. AT VA SO I WANTED TO KNOW AND IT
CAME ACROSS THE PUBLIC LAW, MIND YOU I’M ON THIS PHONE, SO PUBLIC
LAW 113564. IT PROVIDED ELIGIBILITY FOR
MILITARY SEXUAL TRAUMA FOR FEMALE VETERANS OR ANYBODY,
DIDN’T HAVE TO HAVE REFERRAL FROM DOD OR TRICARE, IT WAS
BASICALLY A BILL THAT ALLOWS FEMALE VETERANS TO GO DIRECTLY
TO VA FOR CARE. HOWEVER, WE HAVEN’T HEARD
ANYTHING AS FAR AS WHAT THE UPDATE ON THAT.
UNFORTUNATELY THE LAW WAS SUPPOSED TO HAVE BEEN INACTIVE
ONE YEAR AFTER THE LAW WAS PASSED.>>SO THAT’S A GREAT QUESTION
BOTH BOTH SUSAN AND I ARE FAMILIAR WITH SECTION 4 402.
IT WAS ENACTED, THE VET CENTERS TOOK MAJORITY OF LOAD SO THEIR
PROGRAM HAS SEEN INCREASE SINCE THE LAW PASSED.
NOT AS MUCH MARKETING AS WE WOULD LIKE ON THE PROGRAM BUT WE
ARE WORKING ON IT DOD AND VA IS WORKING CLOSELY, HELPING LEAD
THE DOD COMPONENT OF THAT WITH THE VET CENTERS.
SUSAN AND I WORKED ON IT LOOKING AT THE VA MEDICAL CENTERS AS A
PLACE TO GO AS WELL BUT THERE’S NOTHING IN PLACE RIGHT NOW THAT
PREVENTS ACTIVE DUTY SERVICE MEMBER FROM SEEKING CARE IN THE
VA IF THEY HAVE A SEXUAL ASSAULT.>>DO YOU HAVE ANY DATA ON THAT,
HOW MANY YOU GUYS HAVE SEEN OR HAVE BEEN ACTUALLY SEEN AT THE
VA FOR TREATMENT AND CARE?>>ACTIVE DUTY SERVICE MEMBER
WITH REFERRAL CAN STILL COME TO VA MEDICAL CENTER FOR MST
RELATED CARE. AS KATE MENTIONED WE WORKED ON
THIS FOR MANY YEARS AND THE VET CENTERS WERE ABLE TO IMPLEMENT
THIS WITHIN THE YEAR TIME LINE THAT YOU MENTIONED. THERE WERE MANY CONCERNS IN
TRYING TO ALSO OFFER THESE SERVICES, IT’S BEEN VA MEDICAL
CENTER. ONE WAS THE FIREWALL.
THAT WE WERE CONCERNED THAT VA MEDICAL CENTERS WOULDN’T BE ABLE
TO PROVIDE CONFIDENTIAL CARE FOR THOSE MEMBERS ACTIVE DUTY
MEMBERS, THE VET CENTERS ARE DIFFERENT FROM THE VA MEDICAL
CENTERS IN THEY HAVE A UNIQUE MEDICAL RECORD THAT THERE IS NO
WAY DOD CAN ACCESS THAT MEDICAL RECORD.
SO ALL OF OUR LEADERSHIPS FELT THOUGH IT DIDN’T SPECIFY THIS IN
THE LAW, WHAT THEY WHAT CONGRESS MEANT WAS CONFIDENTIAL
CARE. BECAUSE WITH THE VA WE HAVE TO
MAKE SO MANY MODIFICATIONS WITH OUR IT SYSTEM AND VARIOUS THINGS
TO TRY TONE SURE THAT. THAT THE VA RESPONDS, IT WAS
DECIDED THE VA RESPONSE WOULD BE THAT THEY COULD GO TO THE VET
CENTERS. YOU CAN STILL COME TO THE VA
MEDICAL CENTER WITH A REFERRAL BUT THE VET CENTERS ARE FREE FOR
ACTIVE DUTY SERVICE MEMBERS AND KATE AND MICHAEL FISHER WHO
HEADS UP THE CENTERS ARE WORKING ON RESEARCH MATERIALS AND
GETTING MESSAGES AND THINGS LIKE THAT.
THAT’S A GREAT SECTION AND I THINK IT’S VERY IMPORTANT.>>AND RESPONSE TO THE QUESTION,
HOW MANY, I KNOW MORE THAN 300 BUT I DON’T KNOW THE EXACT
NUMBER. MR. FISHER WOULD HAVE THAT
NUMBER.>>SO THESE ARE COMING, ACTIVE
DUTY SERVICE MEMBERS GOING TO THE VET CENTER WITHOUT ANY REFERRAL FROM DOD WITHOUT ANY
REACH BACK FOR FREE.>>THANK YOU.>>YOU’RE WELCOME.>>MY QUESTION CONCERNS AFTER
CIVILIAN PROVIDERS THAT MAY WANT TO HELP TO BECOME EDUCATED ABOUT
WOMEN VET SERVICES, HOW WILL THE VETS THEN FIND THEM, IS THERE
SOME KIND OF DESIGNATION THEY CAN HAVE SO IF SOMEBODY IS
LOOKING FOR A PROVIDER OR JUST MOVED TO AN AREA, THEY CAN ASK
THE OFFICE, DO YOU HAVE THIS OR THAT, OR ARE YOU VET FRIENDLY,
BUT VET FRIENDLY COULD MEAN ANYTHING.>>ARE YOU IN PARTICULAR ASKING
ABOUT MST RELATED CARE?>>YES.
IF THERE’S PROVIDERS THAT WANT TO HELP AND TAKE THE TRAINING
BUT HOW DO I THAT LET PEOPLE KNOW WHO THEIR SERVICE MEMBERS.>>SO YOUR QUESTION IS HOW WOULD
THE PROVIDER GET CONNECTED.>>YES.>>OKAY.
THANK YOU. AS PART OF THE MISSION ACT,
THERE’S NOW A CAUTION THAT TALKS ABOUT COMPETENCIES IN OUR
COMMUNITY PROVIDERS TO PROVIDE VA CARE BECAUSE THERE IS A
MOVEMENT FOR MORE AND MORE CARE TO BE PROVIDED BY OUTSIDE
PROVIDERS. SO WE ARE JUST STARTING TO WORK
ON THAT. ONE OF THE I AM SPECIFICALLY
MENTIONING IN THE LAW IS COMPETENCY AROUND MST BECAUSE MST IS SPECIFIC TO THE VA.
VA HAS DEVELOPED SPECIALIZED TRAINING FOR THAT.
SO WE ARE CURRENTLY WORKING NOW WITH HOW WE ARE GOING TO ENSURE
OUR PROVIDERS HAVE THAT COMPETENCY AND TRAINING, THE
THERE’S TWO SECTIONS THAT SPEAK TO THAT.
SO I THINK IN THE NEAR FUTURE HAVE A WAY OF BEING PART OF IT
TO GET THE TRAINING TO HAVE THEM TO BE HAVE THOSE COMPETENCIES
THAT THEY WOULD BE PART OF, WHETHER IT BECOMES A PANEL OR
LIKE THE CHOICE PROGRAM, I DON’T KNOW THAT, INFRASTRUCTURE BUT
THERE’S THINGS THAT WORK TO MAKE SURE COMMUNITY PROVIDERS DO HAVE
THE APPROPRIATE TRAINING FOR SOMETHING LIKE MST.>>THANK YOU.>>THANK YOU FOR THOSE EXCELLENT
PRESENTATIONS. WHAT YOUR RECOMMENDATIONS FOR
SCREENING FOR SEXUAL DYSFUNCTION?>>I’M GLAD YOU ASKED THAT
QUESTION. ACTUALLY IN THE MINI RESIDENCY
WE’RE DOING THIS WEEK WE’RE HAVING AN ENTIRE DISCUSSION, VA
AND DOD LOOKING AT TREATMENT FOR SEXUAL DYSFUNCTION.
WE HAVE IDENTIFIED THAT THAT’S A GAP WE NEED TO ACTUALLY BE
WORKING ON. I KNOW IN THE DOD WE RECENTLY
DISCOVERED 28 PROVIDERS THAT ARE CREDENTIALED TO PROVIDE
TREATMENT ACROSS THE ENTIRE DOD BUT THERE’S MANY PEOPLE
DIAGNOSED WITH A SEXUAL DYSFUNCTION WHETHER MALE OR
FEMALE AND WE HAVE SOME LEGISLATIVE CHALLENGES THAT NEED
TO BE ADDRESSED IN ORDER TO BE ABLE TO PROVIDE SUPPORT TO
PROVIDERS TO PROVIDE THAT TREATMENT IN THE DOD AND ON THE
VA SIDE I CAN’T SPEAK FOR THE VA BUT MY CO-SPEAKER THIS WEEK
COMING UP IS ALSO IDENTIFYING IN THE VA THERE’S OPPORTUNITIES FOR
IMPROVEMENT THERE. SO THANKS FOR ASKING THAT
QUESTION.>>I THINK WE HAVE TIME FOR ONE
MORE QUESTION.>>HELLO.
ME AGAIN. SO THE QUESTION I HAVE IS BEING
THAT THE TRAIN FROM LAST YEAR WE HAD A LOT OF SERVICE MEMBERS
THAT GOT DISON RABLY DISCHARGEDED FROM THE MILITARY
AND FINDING THAT A LOT OF THOSE MEMBERS WERE DISHONORABLY
DISCHARGEED FROM MILITARY, ALSO HAVE MILITARY SEXUAL TRAUMA.
BEING THEY ARE NOT IN UPGRADE STATUS, HOW ARE WE TREATING
THOSE INDIVIDUALS THAT HAVE MST? BEING THEY CAN’T GO TO VA
BECAUSE THEY’RE DISHONORABLY DISCHARGED?>>SO I ALSO GLANCE OVER AT
SHURHONDA BECAUSE VETERAN SERVICE ORGANIZATIONS ARE ALWAYS
VERY HELPFUL IN TRYING TO DO WHAT SOMETHING WITH A
DISHONORABLE OTHER THAN HONORABLE DISCHARGE, SO THAT WE
CAN PROVIDE CARE FOR THAT PERSON.
SOMETIMES WE’RE ABLE TO PROVIDE CARE UNDER A HUMANITARIAN STATUS.
THERE IS NOW LAW UNDER THE OMNBUS ACT THAT WE ARE CURRENTLY PURSUING
THAT STATES THAT, AND ITS BIGGER THAN MST, WHAT CAN WE DO FOR THE OTH
FOLKS AND HOW CAN WE PROVIDE THEM WITH AT LEAST SOME FORM OF CARE.
SO THIS IS PART OF THE NEW LEGISLATION THAT HAS JUST HIT THIS YEAR. SO I THINK
WE ARE GOING TO SEE MORE DRAMATIC CHANGES JUST BEYOND VSOS TRYING TO HELP TO GET
THAT CHANGED. SO I AM OPTIMISTIC THAT WE WILL SEE SOME DIFFERENCES. THATS MORE OF
AN ELIGIBILTY QUESTION BUT I KNOW WE ARE BEING CALLED TO BE ASKED TO BE ON COMMITTEES
AND PROVIDE EXPERTISE IN THAT AREA. I THINK THINGS WILL GET BETTER FOR THOSE FOLKS.
I REALLY DO.>>ALRIGHT IM GOING TO SQUEEZE IN ONE MORE
QUESTION AND THATS TO PIGGY BACK ON A PREVIOUS QUESTION TO DR MCGRAW.
IS YOUR RESEARCH EXAMINING THE RISK FACTORS WHICH ARE ASSOCIATED WITH MST AMONG ACTIVE
DUTY PERSONNEL?>>SO IM NOT CONDUCTING ANY RESEARCH MYSELF
BUT IF YOU ARE REFERRING BACK TO THE SYSTEMATIC REVIEW. WE LOOKED, WE USED A CERTAIN NUMBER
OF KEY TERMS AND THEN WE DID A SEARCH FOR RESEARCH
THAT FIT IN THAT BUCKET AND IM HAPPY TO SHARE THAT,
THE FINDINGS OF THE REPORT WITH YOU SPECIFICALLY.
BUT I DON”T RECALL OFF THE TOP OF MY HEAD WHICH STUDIES
ANSWER THAT QUESTION.>>THANK YOU.
>>SURE.>>WELL THIS CONCLUDES OUR SEXUAL ASSAULT AND
MILITARY SEXUAL TRAUMA PANEL SESSION. THANK YOU
ALL FOR YOUR TIME AND ATTENTION.>>APPLAUSE.
>>EVERYONE WE ARE JUST GOING TO TAKE A QUICK FIVE
MINUTE BREAK TO STAND UP AND STRETCH A LITTLE BIT.
AND THEN WE WILL GET STARTED IN THE NEXT SESSION ON
MENTAL HEALTH.